Sabeen Shaikh 0:06
Welcome, everyone. My name is Sabeen Shaikh. I'm with LifeSciences Consultants. And I'm very excited to be here to moderate this panel today. On the stage today we've got some steamed got our colleagues from the industry, Rachel van Straten Stratton-Kirk from Johnson Johnson Bhavesh Barot, from Truffle Capital, and Richard Vincent from fundamental VR. So what we're looking forward to today is to identify the different lenses that are coming into play when it comes to the immersive VR AR opportunity in the surgical theater and operating room. The opportunities that we have today as well as the tailwinds and what we are looking for in the future. My my role with LifeSciences Consultants, I oversee the global med tech practice working with strategics and investors. We work with a number of different companies with deep domain expertise in a number of different areas, including the AR VR space, I'm going to hand it over to my panelists to do an introduction of themselves before we get started with the panel.
Richard Vincent 1:03
Thank you. Pleasure to be here. I'm Richard Vincent. I'm the CEO of fundamental VR, our focus is in the use of spatial computing and VR for acceleration of skills and knowledge. So in the training field ahead of the AOR
Bhavesh Barot 1:21
Thanks, Richard. My name is Bhavesh. I work for a French VC company called Truffle Capital. Truffle Capital is an atypical VC company be more of a venture builder that builds companies from ideation and then takes them all the way through to commercialization. And prior to that, I was working in Medtronic for 17 years and had exposure to several of the technologies there as well.
Rachel Van Stratton-Kirk 1:44
Rachel Van Stratton, I'm part of Johnson &, Johnson Global's Dziedzic marketing, I have a focus on our robotics and digital space. And I managed the strategic like the strategy for our advanced visualization portfolio.
Sabeen Shaikh 2:05
Thank you, everyone. I'm gonna start off with Richard here, Richard, what are some of the tailwinds or sorry, the headwinds that you're seeing from your perspective on the innovation side?
Richard Vincent 2:17
Sure. And it's a pleasure to be here. So thank you for bringing us on to the panel, as I said, so my focus is in very much in that pre operative training, education and skills transfer piece. What we're seeing, really, I guess, in terms of headwinds, is probably two areas. So the first is, you know, the macro economic environment that we've been living in, in the last 18 months. You know, our customers are people in this room, medical device, pharmaceutical businesses looking to accelerate their product adoption. And there isn't one of those organizations that hasn't had a major restructure, moved, a lot of people around or out of those organizations, restructured their budgets, thought hard about how and where they spend. And as a result, innovation, comes under the spotlight. And in some cases, that's meant, perhaps a slower move into this space than we would have otherwise have expected to see. Part of that's because of financial constraint. But but more it's, I think, to do with human nature, which is, again, back to those individuals in those organizations, having gone through those types of changes. The idea of lifting your head above the parapet and saying, Okay, I want to do something different. You know, we've used wet labs categoric labs for this skills transfer for the last 20 years, I think I'd like to do something different to that. And I'd like budget to do run and prove that is quite a hard thing to do. And so I get that there are a number of people who perhaps have pulled back from standing up and saying, actually judge me on a completely new approach. There are, of course, innovators out there, but but a number of them I think, have affected by that. So that's the first one. I think the second one for me, really, in terms of headwinds, is what I call kind of the the trough of disillusionment, in immersive tech or spatial technology. And that is that there are a number of organizations that have done a bit of testing, tried proof of concept, perhaps tried the implementation of VR in my space, with a number of different organizations. And what they found is two things rarely, firstly, perhaps the simulation that they have tops out quite quickly. And so its use with their, their customer base with their health care providers runs out quite quickly, because it doesn't go far enough. And secondly, what they've discovered, probably this is the most fundamental one no pun, is that having an app is just the beginning of the journey, the organizational change the logistics around actually managing that and making it impact hatful for the business is quite a big task. And that's one that we've certainly had to support quite heavily.
Sabeen Shaikh 5:10
One more question related to some of the headwinds that you're seeing what about from the funding side? Because I recognize that we've got an investor here on the panel, I'm curious to hear about any challenges that you've had in that space or that others other startups in your area would have? Sure.
Richard Vincent 5:25
You know, it's an always an interesting cycle, isn't it to the the ebbs and flow of the investment mentality. And there was when I started our business nine years ago, there was immense excitement around VR, probably kind of two years in when people were starting to understand what the potential might be that like, the Gartner Hype Cycle kind of fell off a cliff, at certain point people got a bit bored, and stopped believing. Recently, with the advent of people like Apple coming back into spatial computing that started to reignite interest. I think what we're seeing is that the investor base, believes in the endgame of spatial computing in medical, they're just not sure about the pathway between today and the endpoint. So it's about trying to give that substance.
Sabeen Shaikh 6:21
Thank you for your insights. I'm curious to hear from Rachel, what your thoughts are on the headwinds for this type of technology and some of the things that Richard had just mentioned.
Rachel Van Stratton-Kirk 6:33
Yeah, I think for us, as we are looking at AR and VR, we see there are a lot of applications I think, to Richard's point, it's questions of will the customer adopt using that technology? And depending on what it's for, will they be open and welcome to it? I think you find it's a mixed bag with digital, especially with our customers who are surgeons first assists hospitals? How will they How will they accept that I think it's starting to really gain momentum. But then I think from our side, sometimes it's hard to find the right partner, meaning that there are they do specific niche things, right. So you, you may not find someone who can do multiple applications, they may be very focused in a specific area. So I think for us, having someone with broad applications or broad abilities to meet multiple different VR potential needs, and at times feels like a headwind for us, because it doesn't always feel like one partner can do them all.
Sabeen Shaikh 7:52
I'd like to come back and touch on a couple of things that you mentioned related to the adoption as well as the fragmented nature of this. But before we do that, I'd like to hear from Amish, what some of the headwinds are that you're seeing from the investment side? Yeah,
Bhavesh Barot 8:06
I think, you know, I think everybody in the room knows biggest headwinds is getting access to capital in today's climate. When you've got difficulty getting access to capital, and it's a buyers market, you've really got to have some strong justification, I would say today. And Richard, thanks for schooling in Sherman, some of the literature last week as well. But I don't think it's that prominent in terms of the literature that supports the real world evidence, as we were talking about in arguing for the case there as well. So to be able to advocate for an XR VR solution, to really see the value and the benefit from it, you need to pass through a series of checks. And as an investor looking at identify potential investments, you're gonna check through in terms of the technology, does the technology do what it says? Do they have the right management team to be able to go and realize that those dreams from that standpoint, do they have the ability to get a exit and today's climate is going to be a shorter exit window there as well? And then what's that protection around this as well, from an IP standpoint, and I think these are all some of the challenges there as well. And I was sharing with Richard, you know, in my former days in Medtronic, you know, we would use the XR and VR headset, and I liked the term we used as a standard candy, right. So we would have it on the booth to attract surgeons or physicians to come over. And they would start engaging in a dialogue in a conversation with them. And that's what it was for, but how do you operationalize it as well. So I think there's a there's an opportunity to change that potential misconception and really realize it and I know we'll talk about the tailwinds in a moment, but I think that's that's where we stand today. It's, you know, what's, what's the proof of the technology? Can it really work? You know, have you got the right team? And then people backing it? Am I going to be protected? If I make an investment? What stops? You know somebody else? copying what Richards done and spent years designing? And then how quick am I going to get my money back for this as well. And these are all the challenge that the headwinds that you'll face today and in the future as an innovator.
Sabeen Shaikh 10:25
Thank you. Actually, I'd like to piggyback off of that, before we go back into the adoption opportunity. Rachel, when it comes to some of the points that Bobby has just made related to what type of data is supporting this? What are you seeing from the industry side of things, or strategic side of things?
Rachel Van Stratton-Kirk 10:41
I think, to his point about, we always bring people in, it's exciting, right? It's a great way to get people looking at your technology talking about it. But then on the flip side of that, can we use it for training? Can we use it for potentially troubleshooting? Is it can it be used in a kind of a communal effort in which we're calling in people from other countries and asking, you know, surgeons can actually do like a telepresence with it? Those types of things. So I think, from his, like, where he's going with that, like, is that something that people are really going to be like, Hey, this is worth my time to step away from what I'm working on, and bring all of this into light, let's go get the headsets, let's work on this. There's still questions about that workflow, right? And whether or not surgeons and hospitals and the people that would be involved in using this are really willing to do those things. I think training is a whole other thing. Right, you can definitely walk through training, but to use it in kind of an everyday practice, depending on the applicability. I think for us, that's where we're still a question.
Sabeen Shaikh 12:06
So I guess, going off with that, with the workflow, I guess, opportunity there to fill the gap in. Question for you is that how does that impact the adoption?
Rachel Van Stratton-Kirk 12:21
Oh, we always know if it if it impacts workflow, there is no adoption, or it's minimal adoption. So that's, that's a, that's a guaranteed and that is always something whenever we're investing and or looking at technologies, if it breaks workflow, if it doesn't, and I don't want to use the words doesn't add value, because there are a lot of these things that add value. But when the surgeons are very strapped for time, they have to get a certain number of patients in that day, the Oh, ours are full, those kinds of things break workflow, and they slow things down. And they will just say, you know, I just don't have time, maybe if I have a lighter day, I could use something like that. But if it breaks their workflow, it's, it's a game over.
Sabeen Shaikh 13:11
Richard, out of curiosity, have you found a way to address some workflow opportunities, maybe now or in the future with your technology?
Richard Vincent 13:18
So the point that Rachel was talking about, we're not in that interpretive connection. And certainly, as I talk to surgeons about the use of spatial in that space, it feels at the moment, like it's still we're still looking for the killer app. And you know, there's compromises, compromises in workflow. There's compromises in vision quality, some of those are starting to get fixed. But the workflow one is the big one. Have we solved it? We haven't? No, absolutely not. I am not sure how you do that. You know, again, you're starting to see in some of the tech, the capability to solve some of the other shortcomings. So you know, the vision quality of the new device coming out from Apple, for instance, makes it a contender for the interventional suite suddenly, and you say, well, actually, you could replace those, those different screens that are out there, potentially. But the workflow, everybody has to have their own headset that needs to be charged that needs to be working at the right time in the right way. That's a minefield, navigable perhaps. But I suspect that's not an incremental change. I suspect that's a much bigger kind of O R or cath lab of 2050 type conversation where you actually have to reimagine the whole stack. And I'm not sure who leads them.
Bhavesh Barot 14:38
I can imagine it's going to be from from the imaging companies, just try and see if anyone's here from the imaging companies because I'm sure for anybody who's gone into an interventional suite, especially in a cardiology interventional suite. Right, preoperative you've got these great software's pre op planning tools. You can see everything in 3d you can measure the cost cost fake calcification. You can look at all the valves open and close them And then you go into the cath lab, and you're driving in in fog, you're going to this analog black and white signal, and you're unable to even see properly. And it's like, you know, you feel like you need to kick the TV and try and get the picture quality up there as well. So I would hope that the premise of AR is going to come a lot sooner because it's needed today. And even today, in the intraoperative, imaging tools, there are tools that are already out there on the market, but what they do is that they take a CT image, an MRI image, and then they they record them on loop, and then they superimpose them into the into the cath lab. But what they don't do is do the real time tracking. And when you position in placing a valve or you're trying to find the thrombus, having some tools to able to help you navigate to detect instruments and then be able to understand what Choice of instrument you should use, could could really change change the games there as well. And so I think the headwind is if it's if it's going to disrupt it's gonna cause problems, so the workflow, but if there's able to show that benefit, and that value, add, how you're able to superimpose images and you're able to look around, it could really be a game changer, because at the minute, as you said, they're looking at three, four different images. And that is disrupting the workflow today. From that standpoint.
Rachel Van Stratton-Kirk 16:24
Yeah. Yeah, I think that's where that to your point, it's, it's the we have the pre op imaging, right, you can do the 3d pre op imaging today, but the future state is is how do you get that inter op, you know, you can do external, you can look at better ways for patient positioning port placement, how to anticipate especially like an a thoracic procedure, positioning the patient just right on the table to ensure you're getting to that sub low bar lesion. That kind of thing. Super, super important. Can they help? Can we help provide port placement options? I think those are all things that we know are available to us today. It's that next step, how do we get, you know, how do we get into the interrupt space and have it continue to evolve as well as provide value. But, you know, there are still on the front end, the opportunities just around training and around being able to get people used to utilizing tools that you have available for them without always have to have those tools right there. You know, and I think that's where there is a lot of value to getting ready or are preparing for procedures, having the oh our staff well prepared, well trained through just even a preoperative like VR space.
Sabeen Shaikh 17:57
Thank you. One of the things that you touched on, I think we could probably look into from the tailwind side of things as a future opportunity. Predicting the workflow. So I guess, going into now the next section of the panel discussion is the tail winds. So I'm curious you now hear from let's let's start with you, Babish. What do you think some of the tail comments could be for this type of technology?
Bhavesh Barot 18:21
Sure. Start with the quiet one first, that's good one here. Put a coin in mailman stop. I think the tailwinds for sure. It's what's happened in terms of the pandemic, right, where people like us have have chosen, whether we're going to travel the extra miles, whether we're going to go out of our zone, whether we're going to go out of our facilities to go out and and train. And then also, it's impacted the skill set as well. And, you know, I think one of the things that we're talking about Richard as well, there are more and more residents coming through. And if you speak to a professor, or one of the trained physicians out there, they're always complaining, saying that, you know, these new youngsters coming up, don't have the same hours, they haven't worked as much. And they're not adequately, adequately equipped to actually manage some of these complex cases as well. And so, you know, the challenge that presents today is that, you know, you've got a group of residents that are coming through, you've got shortage of staff. And then you've got these, these restrictions in terms of pointing at you, but I'm saying for the strategics, which is, hey, we need to cut costs, we need to drive profitability, we need to be working more productive and more efficient standpoint. And all of these things, especially from from a VR standpoint, are, you know, perfect opportunity as a tailwind there as well. And so that's where I see great opportunity that you referenced Apple, you know, and I'm sure majority of us here in this room will have an apple and guess what when Apple does something people are going to do it even if it cost $1,500 was for the for the vision Pro is more like 5000 Oh, wow, okay, but it doesn't matter, you do it right. And, and so you'll get physicians ourselves that want to put it on. And I've already seen several strategics that have said now they've created software's. There's an API there. And so that's going to be a great tailwind there as well, from a technology standpoint as well. So I think the you talked about the macro, macro environmental standpoint, you look at what's happening outside, in terms of, you know, limited resources, not enough hours in the day, we need to cut costs, you need to be more productive, need to be more efficient. You've seen this shift in terms of technology. And I think for VR, I think that could be great. And then I've already shared from a from augmented reality standpoint, there's, there's a need today, to be able to capture this and to enable that the physician and see more than the human eye can do. And that's what's the opportunity with AR to be able to go and do that.
Sabeen Shaikh 20:59
Richard, I'm curious to hear your thoughts on some of the tailwinds in a couple of the points that Oddish had mentioned as well, for the opportunities. Sure.
Richard Vincent 21:11
I guess it's the flip side of what I said was the headwind. So you need the proof points, right. If you're going to stand up and say, Actually, I believe I can do this, we can make a difference, whether it's intraoperative, or preoperatively, or training in our use case, surfacing those proof points is key. And that's hard, because every strategic sees that as a competitive advantage. So So bring them into broadcast is a difficult thing. But they're surfacing. Okay, we're seeing it, we're seeing impact on sales, we have customers who are reporting back to us 20% increase in sales as a result of using our platform in market to accelerate the adoption of their product, because they're getting people there faster, we're seeing reduction in cost, we have people on our platform who reporting 50 60% reduction in the training costs, because quite simply, they're not putting teams of eight people on a plane and housing them for a week in an environment to go through for cadaver labs. It's just not happening now with with some of those scenarios, so we're starting to see those things. Of course, you know, we've all done it in our space, we've all spent and invested the time in validation studies to prove efficacy. But real world experiences where the business cases bill, and those are starting to come through. And my job is to try and convince our strategic customers to to allow us to surface those with specific information attached to it. Because that gives you Rachel confidence, then you go, really, so 20% up more sales. That's right. Got to market six months earlier. That's right. reduced cost by 2540 50%. That's right. That's when you go, Okay, I feel confident I'm gonna get up now and go, Yeah, we need to do this differently. Because again, you know, the tailwind is there. But you've got to have to do some due running, you can't, you're not going to say right, get rid of the old way of doing it. And today, we're just gonna go digital, you're gonna run both. So you're gonna run double costs for at least a period of time. And so the more I can get those data points in front of you, the more confidence you'll have to say, actually, we need to do this, this isn't Stan candy. I hate it when it's on a stand. It's not stand candy. This is an accelerant of adoption of a product. And if it isn't that, frankly, it's a waste of money.
Bhavesh Barot 23:34
And I'm sorry, if I can, Rachel is an opportunity. This was something I was doing a Medtronic even before a physician would come to your training center in Cincinnati and Hamburg, wherever it is, it was a prerequisite that they had to go and do some form of didactic training, or some form of even online and the several tools and platforms that I'm gonna plug for them at the moment that you could go and use. And so we had that as a prerequisite before they could come. They've already done that. And so that way, you can then increase your adoption. And so you know, that it's not people coming because they want to go would people choose to go to Cincinnati on a break? Maybe not. But but but maybe in Hamburg, they'd want to go out there and have some fun. And you know, we used to have in Medtronic training centers in in in France and in Strasburg, it's nice and pretty. Can I bring my wife along as well, to actually making sure that there's going to be that adoption there as well. And I think that's where, from from a VR standpoint, as well, if you can make sure that they've done that initial part. And then the last thing before I Shut up, you know, ultimately, you talked about cadaver, but also there's an animal there that that is being used, and then ultimately, the animal is going to be you know, put to sleep. So there's an ethical aspect to that as well. Where I think the VRP is can can really help. Sorry, yeah, no,
Rachel Van Stratton-Kirk 24:49
you're good. Yeah, I agree. I I think for us we're seeing massive tailwinds sales marketing as always, Right, that's a big adopter training, can we use it for broader applications, you may not always get fine skills, right, you may not be able to train the fine skills. But if you can get some of those more macro skills, and then get them closer to being on a system to actually write, I can't I can't drag a robotic platform around from city to city. And I have in my portfolio, I actually have some tools that we are looking at adding to our portfolio, our platform. I can't, those are hands on tools. And I'm trying to figure out a way can I actually turn this into a VR AR type of an environment to just do market research, right, because of that workflow, not the workflow of AR VR, it's the workflow of actually utilizing this tool that from a front end perspective and upstream perspective I want in our strategic portfolio, but it requires me to take equipment all over the world, which is incredibly costly. So I'm looking to see is there an opportunity just for VR to actually meet market research needs so that I can actually have surgeons get hands on with a tool that we're developing in order to get the right feedback and not drag 15 Pelican cases from here to Germany to France to Italy? And so that for us, I feel like the tailwind is there for that. So like I feel like we're getting really to that we've really started perfecting that training area, the the interactions with the tool, people are getting more comfortable with it. So now how can I actually have a selfish, you know, need to be able to put this in for market research, just to get feedback on the tool itself. But I also can't afford to have that take 10 months to develop? Right. So then it's also, how can we get that a little quicker? Yeah, I
Richard Vincent 27:06
think if I come in on that, I think you're absolutely right. I think there's there's enormous potential there for that r&d. Part of it. I think the other thing, though, is, again, it's staying in your space of robotics, you know, we've seen it where, you know, there's a learning curve, right. So let's say it's 50 cases, to get proficient. If you have to do that on the console, using simulation backpack type simulation on a console, then as a physician, I'm probably at the end of a 12 hour shift, I'm then being asked to go and spend an hour or two sitting at a console in a sim center or in a in a Darko are, you know, it's not great. Whereas if you can take that home with you, and go Well, actually, I'll crack into that for a couple of hours. Maybe today, maybe tomorrow morning, at my convenience, you may not get perfect replication. But if you get near perfect replication, and we can get pretty damn close these days, then it's on your terms as a practitioner, you start to say, well, actually, I can get in 20 reps, 30 reps, and then come to the categoric session or come to the the wet lab and conduct the things there. I'm all for saving rabbits. Right. So let's let's rabbit, some pigs, we need to save lots of votes. So we can help a lot on those things.
Sabeen Shaikh 28:28
Bullish I'm curious to hear from your perspective, given the some some of the comments that you made related to the tailwinds that you're seeing from the investor side and the data points that you need to see, to put more money into this type of technology. And then hearing what Richard has said about being able to improve top line revenue, reduce bottom line costs, and then hearing from Rachel as well on what some of the opportunities are within the strategic side of things. How does that change your mind, if at all, from the investment side of what the data points are that you need? So
Bhavesh Barot 28:59
So I think, you know, typically mentioned during the diligence process, or even the initial sort of deal flow process, we'll have various sort of checks and balances, and then you'll go through those stage gates questions to go and see if that technology makes sense. But as part of that diligence process, typically what you'll do is contact one of the strategics, as well. And there'll be it's now in today's climate, several of the strategics to see how likely are you to go and, you know, perform, you know, leverage this technology and depends on how the acquisition would be. But ultimately, the goal would be an exit to to one of the strategics will also combine that with some with some voice of the customer, I think in the previous panel on that talked about GLG using them for quick questions and getting a finger on the boss. But if if if you had a value proposition that said, you know, it could significantly improve the workflow, it could generate revenue, it could have a low cost model and something similar to what Richard does where it doesn't require a lot, a significant cost of capital where you could monetize it. And you could go and get that subscription business. And that repeat business, I'm sure for the right investor would be will be interesting, but depending on their portfolio, and the timing of the fund,
Sabeen Shaikh 30:20
you touched on something that a lot of investors talk about would be the subscription model. Right. And I think that what we're seeing is that there's a lot of different revenue models that are set up with this type of technology. So I think I'm curious to hear from each of you, what are the things that you're seeing most frequently with this type of technology?
Richard Vincent 30:41
It's like, yeah, so subscription model is certainly the route that we prefer to go. Not all of our customers are ready to buy that way. Yeah. And I think it depends in which part of the organization you land as well, in terms of their readiness to go there. So we have some pretty robust discussions with procurement about why you don't want to own this. You actually want to subscribe to it. But but sometimes we have to give way on that one. But I think it is the way forward not not because it works. From an investor standpoint, although it's good for the business, obviously, recurring revenue is a great place to be, I think it works because the pace of change that happens in this technology is such that, actually, if you buy a 2024 vehicle, it's out of date in 2025. Whereas if you subscribe to a plan that says, Actually, you're always going to have the latest vehicle, then you've got a much more equipped solution. And I think that's the way people need to think about it. Certainly, from my perspective, but like I said, Not everyone's ready to go there yet. So we have to ebb and flow on that one.
Sabeen Shaikh 31:51
Okay, Rachel, what type of models are you working with within j&j for this type of technology?
Rachel Van Stratton-Kirk 31:58
Yeah, I think it really depends on the application. You know, from a training perspective, that's going to be on us, right? That's going to be our cost our capital? Investment? I mean, of course, if the hospital wants to purchase one in order to continue ongoing training, then yes, you're looking at subscription type models, where you continue to update the training and software and things like that. I think this continues, as with a lot of digital today is the age old question of how do you monetize it. And that is where we continue to really try to understand because it's, it's again, like a chicken and an egg. Like, if you want people to be willing to try it, you also have to let them have it at either a nominal or no cost, in order for them to uptake adoption. But then when you go back and try to charge for it, then they're like, Well, wait a minute, you gave it to us for free to start. So it is a chicken and egg problem when it comes to digital of any kind, and how you are able to monetize. And I think right now subscriptions are are the best way to go. But then the question is, is do they purchase the capital? Do you ask them to purchase the capital, and then they pay for a certain amount of software upgrades? And how do you do that to maximize not only your ROI, but your customers willingness to to buy and to continue to subscribe?
Bhavesh Barot 33:36
If I can add I think in a in a strategic that's traditionally used to selling devices. It's a different skill set and muscle to be able to sell software as a service as well. And I think several of the strategics have struggled there as well. It's like, what do you mean, we're going to sell it? How are we going to sell it and it's a different muscle. It's a different skill set. And maybe you want to share, you know, the the kind of people that you've brought on in your teams as well, to be able to help you in that journey. Yeah,
Richard Vincent 34:06
I think there's a, as you say, there's a there's a different skill set there. So you have to educate and then drive that that message through. But I think what's interesting for me is rarely, occasionally rather, not really. Occasionally, we'll have somebody table the idea of can we be can we build a financial model that's based on the outcome, the impact, whether that metric is about devices and numbers of devices going through whether it's about cases? And I'm always really intrigued by that, because actually being part of that conversation, the the endpoint is a fantastic thing. We've not managed to take one of those to conclusion yet. They've all fallen over in the process. But I'm all in on that one. I think like we want to have that major impact, and see and share in that. Again, I think at the moment, a lot of the buyers of this technology Whether it's in my space or whether it's in the interpretive space, are finding it hard to account for that type of approach, which is why I think we've not got there yet, but I hope we will in the future.
Sabeen Shaikh 35:14
So I recognize that we're nearing the end of time. And before we close up the panel, what I'd like to do is allow each of the panelists to leave us with one statement, something about their perspective, a thought that they have related to this technology from their lens. And something that would be you heard it here, first, the LSI.
Richard Vincent 35:34
Pritchard first, okay. I didn't get a heads up on this one. So I think that the leave behind for me would be this, from my perspective, this isn't about simulation. This is about virtualization. And by that, I mean taking the logic of the devices of the equipment, and virtualizing it in a way that means that you're not just practicing, you've actually got to use the flight analogy, you've got true flight time you're flying the actual device, in a virtual space, that's where I think the future is in the space that we're operating.
Bhavesh Barot 36:13
I think, you know, in today's climate, the strong will survive. And when I say the strong, it's gonna be the strong value proposition, it's gonna be the strong evidence and the strong data, it's gonna be the strong offering the strong management team as well. And if you have that winning solution, then you're going to be able to go out there and still continue to to thrive within this environment. Within the VR, in the in the AR space, you know, we've talked about it but sort of going beyond the standard candy and going beyond the the gadgetry aspect, which is still great, don't misunderstand me, right? It's great to sort of pull people over to your booth. But, you know, you're not going to be able to, you know, convince leadership to go and acquire a company or spend, you know, hundreds of 1000s of dollars. So I think there's a, there's a need to really show that. And we've talked about it a few times, but really making sure that you're able to quantify it and monetize this opportunity from that standpoint. Yeah.
Rachel Van Stratton-Kirk 37:09
Yeah, I think, I think for this, it's the, as we've seen it progress. It's the continual of like evolution of it, and how it continues to get better. So I think each year, we see more applicability in this space. And for me, I think it's watching it continue to evolve, but supporting it along the way, because we can't just always wait for it to be the best of the best. There is going to be point. So you know, where we started a few years ago, versus where we are today has had huge leaps and bounds. Right, we've got much more usage, much more applicability, much more adoption out there. So as you start moving into the next phase of that, I think you're going to start seeing more adoption. But the technology has to also continue to improve, right? It can't just be about adoption, it has to be the ongoing improvement, as well as the broader applications for us, it's being able to use it more broadly.
Sabeen Shaikh 38:15
Well, that's our panel for today. Like to give a round of applause to our panelists. Thank you for your time. And of course, you can hunt any one of these three panelists down if you've got further questions. Thanks.
I love healthcare and everything that can be achieved with technology across all areas of the continuum. It is the potential of the teams, these technologies and the intersection of where healthcare will be in the future that excites me the most - this passion drives me to stay ahead of the trends and identify what needs to happen now it order to be relevant in the future no matter what your role is in the healthcare ecosystem. I am most proud of my involvement with technologies and teams that ultimately change the standards of care.
A visionary global executive with nearly 20 years of dynamic and broad experiences throughout a corporate commercial and consulting career in the US, Australia and Asia-Pacific regions.
Consult across the entire healthcare ecosystem with strategics (multi-nationals), private equity & venture capital firms, international governments and global growth stage start-ups.
A noted thought leader on a variety topics, I speak on national, regional and global platforms.
I love healthcare and everything that can be achieved with technology across all areas of the continuum. It is the potential of the teams, these technologies and the intersection of where healthcare will be in the future that excites me the most - this passion drives me to stay ahead of the trends and identify what needs to happen now it order to be relevant in the future no matter what your role is in the healthcare ecosystem. I am most proud of my involvement with technologies and teams that ultimately change the standards of care.
A visionary global executive with nearly 20 years of dynamic and broad experiences throughout a corporate commercial and consulting career in the US, Australia and Asia-Pacific regions.
Consult across the entire healthcare ecosystem with strategics (multi-nationals), private equity & venture capital firms, international governments and global growth stage start-ups.
A noted thought leader on a variety topics, I speak on national, regional and global platforms.
With over 18 years of experience in the MedTech industry, I am a seasoned healthcare
executive known for successfully guiding commercial teams in diverse markets and
segments. My expertise encompasses strategy, sales, marketing, product development, key account management, and new business development, all geared towards driving sustainable, profitable growth and fostering innovation. I have now pivoted into the world of Venture Capital, heading up MedTech business development at Truffle Capital, where I aim to facilitate the emergence of disruptive innovations to the market.
With over 18 years of experience in the MedTech industry, I am a seasoned healthcare
executive known for successfully guiding commercial teams in diverse markets and
segments. My expertise encompasses strategy, sales, marketing, product development, key account management, and new business development, all geared towards driving sustainable, profitable growth and fostering innovation. I have now pivoted into the world of Venture Capital, heading up MedTech business development at Truffle Capital, where I aim to facilitate the emergence of disruptive innovations to the market.
25+ years’ experience of building international businesses and has throughout his career sought opportunities for positive market disruption through technological application. It was this desire that led him to co-found FundamentalVR to help address an age-old problem for the medical market; how to create safe, realistic, measurable spaces to learn and develop skills. In his role as CEO Richard is working at the intersection of immersive and haptic technologies and is responsible for building a world class team of medical, learning, data insights and technologist who together can realise the company’s ambition of creating the world’s first global, haptically enabled, low cost ‘flight simulator for surgeons’.
25+ years’ experience of building international businesses and has throughout his career sought opportunities for positive market disruption through technological application. It was this desire that led him to co-found FundamentalVR to help address an age-old problem for the medical market; how to create safe, realistic, measurable spaces to learn and develop skills. In his role as CEO Richard is working at the intersection of immersive and haptic technologies and is responsible for building a world class team of medical, learning, data insights and technologist who together can realise the company’s ambition of creating the world’s first global, haptically enabled, low cost ‘flight simulator for surgeons’.
Sabeen Shaikh 0:06
Welcome, everyone. My name is Sabeen Shaikh. I'm with LifeSciences Consultants. And I'm very excited to be here to moderate this panel today. On the stage today we've got some steamed got our colleagues from the industry, Rachel van Straten Stratton-Kirk from Johnson Johnson Bhavesh Barot, from Truffle Capital, and Richard Vincent from fundamental VR. So what we're looking forward to today is to identify the different lenses that are coming into play when it comes to the immersive VR AR opportunity in the surgical theater and operating room. The opportunities that we have today as well as the tailwinds and what we are looking for in the future. My my role with LifeSciences Consultants, I oversee the global med tech practice working with strategics and investors. We work with a number of different companies with deep domain expertise in a number of different areas, including the AR VR space, I'm going to hand it over to my panelists to do an introduction of themselves before we get started with the panel.
Richard Vincent 1:03
Thank you. Pleasure to be here. I'm Richard Vincent. I'm the CEO of fundamental VR, our focus is in the use of spatial computing and VR for acceleration of skills and knowledge. So in the training field ahead of the AOR
Bhavesh Barot 1:21
Thanks, Richard. My name is Bhavesh. I work for a French VC company called Truffle Capital. Truffle Capital is an atypical VC company be more of a venture builder that builds companies from ideation and then takes them all the way through to commercialization. And prior to that, I was working in Medtronic for 17 years and had exposure to several of the technologies there as well.
Rachel Van Stratton-Kirk 1:44
Rachel Van Stratton, I'm part of Johnson &, Johnson Global's Dziedzic marketing, I have a focus on our robotics and digital space. And I managed the strategic like the strategy for our advanced visualization portfolio.
Sabeen Shaikh 2:05
Thank you, everyone. I'm gonna start off with Richard here, Richard, what are some of the tailwinds or sorry, the headwinds that you're seeing from your perspective on the innovation side?
Richard Vincent 2:17
Sure. And it's a pleasure to be here. So thank you for bringing us on to the panel, as I said, so my focus is in very much in that pre operative training, education and skills transfer piece. What we're seeing, really, I guess, in terms of headwinds, is probably two areas. So the first is, you know, the macro economic environment that we've been living in, in the last 18 months. You know, our customers are people in this room, medical device, pharmaceutical businesses looking to accelerate their product adoption. And there isn't one of those organizations that hasn't had a major restructure, moved, a lot of people around or out of those organizations, restructured their budgets, thought hard about how and where they spend. And as a result, innovation, comes under the spotlight. And in some cases, that's meant, perhaps a slower move into this space than we would have otherwise have expected to see. Part of that's because of financial constraint. But but more it's, I think, to do with human nature, which is, again, back to those individuals in those organizations, having gone through those types of changes. The idea of lifting your head above the parapet and saying, Okay, I want to do something different. You know, we've used wet labs categoric labs for this skills transfer for the last 20 years, I think I'd like to do something different to that. And I'd like budget to do run and prove that is quite a hard thing to do. And so I get that there are a number of people who perhaps have pulled back from standing up and saying, actually judge me on a completely new approach. There are, of course, innovators out there, but but a number of them I think, have affected by that. So that's the first one. I think the second one for me, really, in terms of headwinds, is what I call kind of the the trough of disillusionment, in immersive tech or spatial technology. And that is that there are a number of organizations that have done a bit of testing, tried proof of concept, perhaps tried the implementation of VR in my space, with a number of different organizations. And what they found is two things rarely, firstly, perhaps the simulation that they have tops out quite quickly. And so its use with their, their customer base with their health care providers runs out quite quickly, because it doesn't go far enough. And secondly, what they've discovered, probably this is the most fundamental one no pun, is that having an app is just the beginning of the journey, the organizational change the logistics around actually managing that and making it impact hatful for the business is quite a big task. And that's one that we've certainly had to support quite heavily.
Sabeen Shaikh 5:10
One more question related to some of the headwinds that you're seeing what about from the funding side? Because I recognize that we've got an investor here on the panel, I'm curious to hear about any challenges that you've had in that space or that others other startups in your area would have? Sure.
Richard Vincent 5:25
You know, it's an always an interesting cycle, isn't it to the the ebbs and flow of the investment mentality. And there was when I started our business nine years ago, there was immense excitement around VR, probably kind of two years in when people were starting to understand what the potential might be that like, the Gartner Hype Cycle kind of fell off a cliff, at certain point people got a bit bored, and stopped believing. Recently, with the advent of people like Apple coming back into spatial computing that started to reignite interest. I think what we're seeing is that the investor base, believes in the endgame of spatial computing in medical, they're just not sure about the pathway between today and the endpoint. So it's about trying to give that substance.
Sabeen Shaikh 6:21
Thank you for your insights. I'm curious to hear from Rachel, what your thoughts are on the headwinds for this type of technology and some of the things that Richard had just mentioned.
Rachel Van Stratton-Kirk 6:33
Yeah, I think for us, as we are looking at AR and VR, we see there are a lot of applications I think, to Richard's point, it's questions of will the customer adopt using that technology? And depending on what it's for, will they be open and welcome to it? I think you find it's a mixed bag with digital, especially with our customers who are surgeons first assists hospitals? How will they How will they accept that I think it's starting to really gain momentum. But then I think from our side, sometimes it's hard to find the right partner, meaning that there are they do specific niche things, right. So you, you may not find someone who can do multiple applications, they may be very focused in a specific area. So I think for us, having someone with broad applications or broad abilities to meet multiple different VR potential needs, and at times feels like a headwind for us, because it doesn't always feel like one partner can do them all.
Sabeen Shaikh 7:52
I'd like to come back and touch on a couple of things that you mentioned related to the adoption as well as the fragmented nature of this. But before we do that, I'd like to hear from Amish, what some of the headwinds are that you're seeing from the investment side? Yeah,
Bhavesh Barot 8:06
I think, you know, I think everybody in the room knows biggest headwinds is getting access to capital in today's climate. When you've got difficulty getting access to capital, and it's a buyers market, you've really got to have some strong justification, I would say today. And Richard, thanks for schooling in Sherman, some of the literature last week as well. But I don't think it's that prominent in terms of the literature that supports the real world evidence, as we were talking about in arguing for the case there as well. So to be able to advocate for an XR VR solution, to really see the value and the benefit from it, you need to pass through a series of checks. And as an investor looking at identify potential investments, you're gonna check through in terms of the technology, does the technology do what it says? Do they have the right management team to be able to go and realize that those dreams from that standpoint, do they have the ability to get a exit and today's climate is going to be a shorter exit window there as well? And then what's that protection around this as well, from an IP standpoint, and I think these are all some of the challenges there as well. And I was sharing with Richard, you know, in my former days in Medtronic, you know, we would use the XR and VR headset, and I liked the term we used as a standard candy, right. So we would have it on the booth to attract surgeons or physicians to come over. And they would start engaging in a dialogue in a conversation with them. And that's what it was for, but how do you operationalize it as well. So I think there's a there's an opportunity to change that potential misconception and really realize it and I know we'll talk about the tailwinds in a moment, but I think that's that's where we stand today. It's, you know, what's, what's the proof of the technology? Can it really work? You know, have you got the right team? And then people backing it? Am I going to be protected? If I make an investment? What stops? You know somebody else? copying what Richards done and spent years designing? And then how quick am I going to get my money back for this as well. And these are all the challenge that the headwinds that you'll face today and in the future as an innovator.
Sabeen Shaikh 10:25
Thank you. Actually, I'd like to piggyback off of that, before we go back into the adoption opportunity. Rachel, when it comes to some of the points that Bobby has just made related to what type of data is supporting this? What are you seeing from the industry side of things, or strategic side of things?
Rachel Van Stratton-Kirk 10:41
I think, to his point about, we always bring people in, it's exciting, right? It's a great way to get people looking at your technology talking about it. But then on the flip side of that, can we use it for training? Can we use it for potentially troubleshooting? Is it can it be used in a kind of a communal effort in which we're calling in people from other countries and asking, you know, surgeons can actually do like a telepresence with it? Those types of things. So I think, from his, like, where he's going with that, like, is that something that people are really going to be like, Hey, this is worth my time to step away from what I'm working on, and bring all of this into light, let's go get the headsets, let's work on this. There's still questions about that workflow, right? And whether or not surgeons and hospitals and the people that would be involved in using this are really willing to do those things. I think training is a whole other thing. Right, you can definitely walk through training, but to use it in kind of an everyday practice, depending on the applicability. I think for us, that's where we're still a question.
Sabeen Shaikh 12:06
So I guess, going off with that, with the workflow, I guess, opportunity there to fill the gap in. Question for you is that how does that impact the adoption?
Rachel Van Stratton-Kirk 12:21
Oh, we always know if it if it impacts workflow, there is no adoption, or it's minimal adoption. So that's, that's a, that's a guaranteed and that is always something whenever we're investing and or looking at technologies, if it breaks workflow, if it doesn't, and I don't want to use the words doesn't add value, because there are a lot of these things that add value. But when the surgeons are very strapped for time, they have to get a certain number of patients in that day, the Oh, ours are full, those kinds of things break workflow, and they slow things down. And they will just say, you know, I just don't have time, maybe if I have a lighter day, I could use something like that. But if it breaks their workflow, it's, it's a game over.
Sabeen Shaikh 13:11
Richard, out of curiosity, have you found a way to address some workflow opportunities, maybe now or in the future with your technology?
Richard Vincent 13:18
So the point that Rachel was talking about, we're not in that interpretive connection. And certainly, as I talk to surgeons about the use of spatial in that space, it feels at the moment, like it's still we're still looking for the killer app. And you know, there's compromises, compromises in workflow. There's compromises in vision quality, some of those are starting to get fixed. But the workflow one is the big one. Have we solved it? We haven't? No, absolutely not. I am not sure how you do that. You know, again, you're starting to see in some of the tech, the capability to solve some of the other shortcomings. So you know, the vision quality of the new device coming out from Apple, for instance, makes it a contender for the interventional suite suddenly, and you say, well, actually, you could replace those, those different screens that are out there, potentially. But the workflow, everybody has to have their own headset that needs to be charged that needs to be working at the right time in the right way. That's a minefield, navigable perhaps. But I suspect that's not an incremental change. I suspect that's a much bigger kind of O R or cath lab of 2050 type conversation where you actually have to reimagine the whole stack. And I'm not sure who leads them.
Bhavesh Barot 14:38
I can imagine it's going to be from from the imaging companies, just try and see if anyone's here from the imaging companies because I'm sure for anybody who's gone into an interventional suite, especially in a cardiology interventional suite. Right, preoperative you've got these great software's pre op planning tools. You can see everything in 3d you can measure the cost cost fake calcification. You can look at all the valves open and close them And then you go into the cath lab, and you're driving in in fog, you're going to this analog black and white signal, and you're unable to even see properly. And it's like, you know, you feel like you need to kick the TV and try and get the picture quality up there as well. So I would hope that the premise of AR is going to come a lot sooner because it's needed today. And even today, in the intraoperative, imaging tools, there are tools that are already out there on the market, but what they do is that they take a CT image, an MRI image, and then they they record them on loop, and then they superimpose them into the into the cath lab. But what they don't do is do the real time tracking. And when you position in placing a valve or you're trying to find the thrombus, having some tools to able to help you navigate to detect instruments and then be able to understand what Choice of instrument you should use, could could really change change the games there as well. And so I think the headwind is if it's if it's going to disrupt it's gonna cause problems, so the workflow, but if there's able to show that benefit, and that value, add, how you're able to superimpose images and you're able to look around, it could really be a game changer, because at the minute, as you said, they're looking at three, four different images. And that is disrupting the workflow today. From that standpoint.
Rachel Van Stratton-Kirk 16:24
Yeah. Yeah, I think that's where that to your point, it's, it's the we have the pre op imaging, right, you can do the 3d pre op imaging today, but the future state is is how do you get that inter op, you know, you can do external, you can look at better ways for patient positioning port placement, how to anticipate especially like an a thoracic procedure, positioning the patient just right on the table to ensure you're getting to that sub low bar lesion. That kind of thing. Super, super important. Can they help? Can we help provide port placement options? I think those are all things that we know are available to us today. It's that next step, how do we get, you know, how do we get into the interrupt space and have it continue to evolve as well as provide value. But, you know, there are still on the front end, the opportunities just around training and around being able to get people used to utilizing tools that you have available for them without always have to have those tools right there. You know, and I think that's where there is a lot of value to getting ready or are preparing for procedures, having the oh our staff well prepared, well trained through just even a preoperative like VR space.
Sabeen Shaikh 17:57
Thank you. One of the things that you touched on, I think we could probably look into from the tailwind side of things as a future opportunity. Predicting the workflow. So I guess, going into now the next section of the panel discussion is the tail winds. So I'm curious you now hear from let's let's start with you, Babish. What do you think some of the tail comments could be for this type of technology?
Bhavesh Barot 18:21
Sure. Start with the quiet one first, that's good one here. Put a coin in mailman stop. I think the tailwinds for sure. It's what's happened in terms of the pandemic, right, where people like us have have chosen, whether we're going to travel the extra miles, whether we're going to go out of our zone, whether we're going to go out of our facilities to go out and and train. And then also, it's impacted the skill set as well. And, you know, I think one of the things that we're talking about Richard as well, there are more and more residents coming through. And if you speak to a professor, or one of the trained physicians out there, they're always complaining, saying that, you know, these new youngsters coming up, don't have the same hours, they haven't worked as much. And they're not adequately, adequately equipped to actually manage some of these complex cases as well. And so, you know, the challenge that presents today is that, you know, you've got a group of residents that are coming through, you've got shortage of staff. And then you've got these, these restrictions in terms of pointing at you, but I'm saying for the strategics, which is, hey, we need to cut costs, we need to drive profitability, we need to be working more productive and more efficient standpoint. And all of these things, especially from from a VR standpoint, are, you know, perfect opportunity as a tailwind there as well. And so that's where I see great opportunity that you referenced Apple, you know, and I'm sure majority of us here in this room will have an apple and guess what when Apple does something people are going to do it even if it cost $1,500 was for the for the vision Pro is more like 5000 Oh, wow, okay, but it doesn't matter, you do it right. And, and so you'll get physicians ourselves that want to put it on. And I've already seen several strategics that have said now they've created software's. There's an API there. And so that's going to be a great tailwind there as well, from a technology standpoint as well. So I think the you talked about the macro, macro environmental standpoint, you look at what's happening outside, in terms of, you know, limited resources, not enough hours in the day, we need to cut costs, you need to be more productive, need to be more efficient. You've seen this shift in terms of technology. And I think for VR, I think that could be great. And then I've already shared from a from augmented reality standpoint, there's, there's a need today, to be able to capture this and to enable that the physician and see more than the human eye can do. And that's what's the opportunity with AR to be able to go and do that.
Sabeen Shaikh 20:59
Richard, I'm curious to hear your thoughts on some of the tailwinds in a couple of the points that Oddish had mentioned as well, for the opportunities. Sure.
Richard Vincent 21:11
I guess it's the flip side of what I said was the headwind. So you need the proof points, right. If you're going to stand up and say, Actually, I believe I can do this, we can make a difference, whether it's intraoperative, or preoperatively, or training in our use case, surfacing those proof points is key. And that's hard, because every strategic sees that as a competitive advantage. So So bring them into broadcast is a difficult thing. But they're surfacing. Okay, we're seeing it, we're seeing impact on sales, we have customers who are reporting back to us 20% increase in sales as a result of using our platform in market to accelerate the adoption of their product, because they're getting people there faster, we're seeing reduction in cost, we have people on our platform who reporting 50 60% reduction in the training costs, because quite simply, they're not putting teams of eight people on a plane and housing them for a week in an environment to go through for cadaver labs. It's just not happening now with with some of those scenarios, so we're starting to see those things. Of course, you know, we've all done it in our space, we've all spent and invested the time in validation studies to prove efficacy. But real world experiences where the business cases bill, and those are starting to come through. And my job is to try and convince our strategic customers to to allow us to surface those with specific information attached to it. Because that gives you Rachel confidence, then you go, really, so 20% up more sales. That's right. Got to market six months earlier. That's right. reduced cost by 2540 50%. That's right. That's when you go, Okay, I feel confident I'm gonna get up now and go, Yeah, we need to do this differently. Because again, you know, the tailwind is there. But you've got to have to do some due running, you can't, you're not going to say right, get rid of the old way of doing it. And today, we're just gonna go digital, you're gonna run both. So you're gonna run double costs for at least a period of time. And so the more I can get those data points in front of you, the more confidence you'll have to say, actually, we need to do this, this isn't Stan candy. I hate it when it's on a stand. It's not stand candy. This is an accelerant of adoption of a product. And if it isn't that, frankly, it's a waste of money.
Bhavesh Barot 23:34
And I'm sorry, if I can, Rachel is an opportunity. This was something I was doing a Medtronic even before a physician would come to your training center in Cincinnati and Hamburg, wherever it is, it was a prerequisite that they had to go and do some form of didactic training, or some form of even online and the several tools and platforms that I'm gonna plug for them at the moment that you could go and use. And so we had that as a prerequisite before they could come. They've already done that. And so that way, you can then increase your adoption. And so you know, that it's not people coming because they want to go would people choose to go to Cincinnati on a break? Maybe not. But but but maybe in Hamburg, they'd want to go out there and have some fun. And you know, we used to have in Medtronic training centers in in in France and in Strasburg, it's nice and pretty. Can I bring my wife along as well, to actually making sure that there's going to be that adoption there as well. And I think that's where, from from a VR standpoint, as well, if you can make sure that they've done that initial part. And then the last thing before I Shut up, you know, ultimately, you talked about cadaver, but also there's an animal there that that is being used, and then ultimately, the animal is going to be you know, put to sleep. So there's an ethical aspect to that as well. Where I think the VRP is can can really help. Sorry, yeah, no,
Rachel Van Stratton-Kirk 24:49
you're good. Yeah, I agree. I I think for us we're seeing massive tailwinds sales marketing as always, Right, that's a big adopter training, can we use it for broader applications, you may not always get fine skills, right, you may not be able to train the fine skills. But if you can get some of those more macro skills, and then get them closer to being on a system to actually write, I can't I can't drag a robotic platform around from city to city. And I have in my portfolio, I actually have some tools that we are looking at adding to our portfolio, our platform. I can't, those are hands on tools. And I'm trying to figure out a way can I actually turn this into a VR AR type of an environment to just do market research, right, because of that workflow, not the workflow of AR VR, it's the workflow of actually utilizing this tool that from a front end perspective and upstream perspective I want in our strategic portfolio, but it requires me to take equipment all over the world, which is incredibly costly. So I'm looking to see is there an opportunity just for VR to actually meet market research needs so that I can actually have surgeons get hands on with a tool that we're developing in order to get the right feedback and not drag 15 Pelican cases from here to Germany to France to Italy? And so that for us, I feel like the tailwind is there for that. So like I feel like we're getting really to that we've really started perfecting that training area, the the interactions with the tool, people are getting more comfortable with it. So now how can I actually have a selfish, you know, need to be able to put this in for market research, just to get feedback on the tool itself. But I also can't afford to have that take 10 months to develop? Right. So then it's also, how can we get that a little quicker? Yeah, I
Richard Vincent 27:06
think if I come in on that, I think you're absolutely right. I think there's there's enormous potential there for that r&d. Part of it. I think the other thing, though, is, again, it's staying in your space of robotics, you know, we've seen it where, you know, there's a learning curve, right. So let's say it's 50 cases, to get proficient. If you have to do that on the console, using simulation backpack type simulation on a console, then as a physician, I'm probably at the end of a 12 hour shift, I'm then being asked to go and spend an hour or two sitting at a console in a sim center or in a in a Darko are, you know, it's not great. Whereas if you can take that home with you, and go Well, actually, I'll crack into that for a couple of hours. Maybe today, maybe tomorrow morning, at my convenience, you may not get perfect replication. But if you get near perfect replication, and we can get pretty damn close these days, then it's on your terms as a practitioner, you start to say, well, actually, I can get in 20 reps, 30 reps, and then come to the categoric session or come to the the wet lab and conduct the things there. I'm all for saving rabbits. Right. So let's let's rabbit, some pigs, we need to save lots of votes. So we can help a lot on those things.
Sabeen Shaikh 28:28
Bullish I'm curious to hear from your perspective, given the some some of the comments that you made related to the tailwinds that you're seeing from the investor side and the data points that you need to see, to put more money into this type of technology. And then hearing what Richard has said about being able to improve top line revenue, reduce bottom line costs, and then hearing from Rachel as well on what some of the opportunities are within the strategic side of things. How does that change your mind, if at all, from the investment side of what the data points are that you need? So
Bhavesh Barot 28:59
So I think, you know, typically mentioned during the diligence process, or even the initial sort of deal flow process, we'll have various sort of checks and balances, and then you'll go through those stage gates questions to go and see if that technology makes sense. But as part of that diligence process, typically what you'll do is contact one of the strategics, as well. And there'll be it's now in today's climate, several of the strategics to see how likely are you to go and, you know, perform, you know, leverage this technology and depends on how the acquisition would be. But ultimately, the goal would be an exit to to one of the strategics will also combine that with some with some voice of the customer, I think in the previous panel on that talked about GLG using them for quick questions and getting a finger on the boss. But if if if you had a value proposition that said, you know, it could significantly improve the workflow, it could generate revenue, it could have a low cost model and something similar to what Richard does where it doesn't require a lot, a significant cost of capital where you could monetize it. And you could go and get that subscription business. And that repeat business, I'm sure for the right investor would be will be interesting, but depending on their portfolio, and the timing of the fund,
Sabeen Shaikh 30:20
you touched on something that a lot of investors talk about would be the subscription model. Right. And I think that what we're seeing is that there's a lot of different revenue models that are set up with this type of technology. So I think I'm curious to hear from each of you, what are the things that you're seeing most frequently with this type of technology?
Richard Vincent 30:41
It's like, yeah, so subscription model is certainly the route that we prefer to go. Not all of our customers are ready to buy that way. Yeah. And I think it depends in which part of the organization you land as well, in terms of their readiness to go there. So we have some pretty robust discussions with procurement about why you don't want to own this. You actually want to subscribe to it. But but sometimes we have to give way on that one. But I think it is the way forward not not because it works. From an investor standpoint, although it's good for the business, obviously, recurring revenue is a great place to be, I think it works because the pace of change that happens in this technology is such that, actually, if you buy a 2024 vehicle, it's out of date in 2025. Whereas if you subscribe to a plan that says, Actually, you're always going to have the latest vehicle, then you've got a much more equipped solution. And I think that's the way people need to think about it. Certainly, from my perspective, but like I said, Not everyone's ready to go there yet. So we have to ebb and flow on that one.
Sabeen Shaikh 31:51
Okay, Rachel, what type of models are you working with within j&j for this type of technology?
Rachel Van Stratton-Kirk 31:58
Yeah, I think it really depends on the application. You know, from a training perspective, that's going to be on us, right? That's going to be our cost our capital? Investment? I mean, of course, if the hospital wants to purchase one in order to continue ongoing training, then yes, you're looking at subscription type models, where you continue to update the training and software and things like that. I think this continues, as with a lot of digital today is the age old question of how do you monetize it. And that is where we continue to really try to understand because it's, it's again, like a chicken and an egg. Like, if you want people to be willing to try it, you also have to let them have it at either a nominal or no cost, in order for them to uptake adoption. But then when you go back and try to charge for it, then they're like, Well, wait a minute, you gave it to us for free to start. So it is a chicken and egg problem when it comes to digital of any kind, and how you are able to monetize. And I think right now subscriptions are are the best way to go. But then the question is, is do they purchase the capital? Do you ask them to purchase the capital, and then they pay for a certain amount of software upgrades? And how do you do that to maximize not only your ROI, but your customers willingness to to buy and to continue to subscribe?
Bhavesh Barot 33:36
If I can add I think in a in a strategic that's traditionally used to selling devices. It's a different skill set and muscle to be able to sell software as a service as well. And I think several of the strategics have struggled there as well. It's like, what do you mean, we're going to sell it? How are we going to sell it and it's a different muscle. It's a different skill set. And maybe you want to share, you know, the the kind of people that you've brought on in your teams as well, to be able to help you in that journey. Yeah,
Richard Vincent 34:06
I think there's a, as you say, there's a there's a different skill set there. So you have to educate and then drive that that message through. But I think what's interesting for me is rarely, occasionally rather, not really. Occasionally, we'll have somebody table the idea of can we be can we build a financial model that's based on the outcome, the impact, whether that metric is about devices and numbers of devices going through whether it's about cases? And I'm always really intrigued by that, because actually being part of that conversation, the the endpoint is a fantastic thing. We've not managed to take one of those to conclusion yet. They've all fallen over in the process. But I'm all in on that one. I think like we want to have that major impact, and see and share in that. Again, I think at the moment, a lot of the buyers of this technology Whether it's in my space or whether it's in the interpretive space, are finding it hard to account for that type of approach, which is why I think we've not got there yet, but I hope we will in the future.
Sabeen Shaikh 35:14
So I recognize that we're nearing the end of time. And before we close up the panel, what I'd like to do is allow each of the panelists to leave us with one statement, something about their perspective, a thought that they have related to this technology from their lens. And something that would be you heard it here, first, the LSI.
Richard Vincent 35:34
Pritchard first, okay. I didn't get a heads up on this one. So I think that the leave behind for me would be this, from my perspective, this isn't about simulation. This is about virtualization. And by that, I mean taking the logic of the devices of the equipment, and virtualizing it in a way that means that you're not just practicing, you've actually got to use the flight analogy, you've got true flight time you're flying the actual device, in a virtual space, that's where I think the future is in the space that we're operating.
Bhavesh Barot 36:13
I think, you know, in today's climate, the strong will survive. And when I say the strong, it's gonna be the strong value proposition, it's gonna be the strong evidence and the strong data, it's gonna be the strong offering the strong management team as well. And if you have that winning solution, then you're going to be able to go out there and still continue to to thrive within this environment. Within the VR, in the in the AR space, you know, we've talked about it but sort of going beyond the standard candy and going beyond the the gadgetry aspect, which is still great, don't misunderstand me, right? It's great to sort of pull people over to your booth. But, you know, you're not going to be able to, you know, convince leadership to go and acquire a company or spend, you know, hundreds of 1000s of dollars. So I think there's a, there's a need to really show that. And we've talked about it a few times, but really making sure that you're able to quantify it and monetize this opportunity from that standpoint. Yeah.
Rachel Van Stratton-Kirk 37:09
Yeah, I think, I think for this, it's the, as we've seen it progress. It's the continual of like evolution of it, and how it continues to get better. So I think each year, we see more applicability in this space. And for me, I think it's watching it continue to evolve, but supporting it along the way, because we can't just always wait for it to be the best of the best. There is going to be point. So you know, where we started a few years ago, versus where we are today has had huge leaps and bounds. Right, we've got much more usage, much more applicability, much more adoption out there. So as you start moving into the next phase of that, I think you're going to start seeing more adoption. But the technology has to also continue to improve, right? It can't just be about adoption, it has to be the ongoing improvement, as well as the broader applications for us, it's being able to use it more broadly.
Sabeen Shaikh 38:15
Well, that's our panel for today. Like to give a round of applause to our panelists. Thank you for your time. And of course, you can hunt any one of these three panelists down if you've got further questions. Thanks.
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